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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
S
D
I
A
G
N
O
S
I
S
S
F
F
V
A
P
G
A
J
V
U
E
G
D
L
C
B
W
P
R
B
W
X
V
L
X
D
M
O
E
S
I
S
E
L
H
G
Z
K
D
C
Q
E
R
S
E
O
V
B
I
R
J
G
A
T
B
C
V
J
V
I
Z
R
C
E
K
Y
A
V
O
B
S
A
I
T
M
T
P
L
R
E
N
H
D
A
C
N
S
S
P
R
O
C
E
D
U
R
E
P
M
M
V
Y
M
B
Y
K
K
P
J
R
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